Chill out with delicious summer meals! See page 14 healthtoday women’s summer 2008 Are you sun-smart? Take our quiz! Vanessa Williams enjoys the simple pleasures The Christ Hospital 2139 Auburn Avenue Cincinnati OH 45219 non-profit org us postage Paid cincinnati oh Permit #5489 Mood &food Put an end to emotional eating Wayne’s Story — Detecting Heart Risk A Here for me. s a building inspector, Wayne knows the importance of paying attention to the little things. Because the small things can make a big difference — especially when it comes to matters of the heart. When Wayne’s wife, Marge, heard about heart-risk detection offerings at The Christ Hospital, she signed them both up for a screening. Thanks to the Heart CT Scan, which detected some abnormalities that weren’t detected through other screening methods, Wayne avoided major surgery — and they both avoided heartache. By offering the Heart CT Scan at a reduced rate of $99, more members of our community are able to get screened — and get the heart care they need. To schedule a Heart CT Scan that will help determine your risk for heart disease, call 513-585-2668. Wayne and Marge couldn’t be happier that The Christ Hospital was here. Just like it is and will always be. Here. For you. 2139 Auburn Avenue | Cincinnati, OH 45219 | 513-585-2000 | www.TheChristHospital.com in this issue . . . 2 L E T T E R F R O M T H E F O U N D E R 8 Enjoy a healthy summer! 3 o more pain N A nonsurgical treatment for uterine fibroids 4Safe summer fun How to keep sports injuries at bay 5Garden without pain! 6 H E A L T H H E A D L I N E S What’s making news in women’s health 8 E njoying the simple pleasures “Ugly Betty” beauty Vanessa Williams finds happiness at home 11 S E X & G E N D E R M A T T E R S Diabetes and sex 14 Not always the best partners 14 H E A L T H Y B I T E S Can’t stand the heat? Get out of the kitchen! 16Headache help 17Skin type your sunscreen Find the right protection for your skin 18 ontrolling cancer’s side effects C Is complementary therapy right for you? 20 W aiting for baby 21 Reduce your risks for premature birth The food-mood connection 22H E A L T H Y M O V E S Don’t let obesity prevent activity 24H E A L T H S M A R T S Are you sun-smart? 17 healthtoday women’s Letter from the founder the magazine of t h e f o u n d a t i o n f o r f e m a l e h e a l t h a w a r e n e ss Enjoy a healthy summer! Founders Mickey M. Karram, MD / Mona Karram National Advisory Board I f you and your family plan on spending plenty of time outdoors this summer, don’t forget to protect yourself from the sun’s damaging rays. In this issue of Women’s Health Today, you’ll read about the difference between UVA and UVB rays, the protection sunscreens can give you and how to stay safe (“Skin type your sunscreen,” page 17). After you’ve slathered on the sunscreen, fire up the grill and turn on the blender to prepare a delicious meal for your family and guests. Avoid that oven and enjoy healthy gazpacho, fruit salad with quinoa and grilled pork with vegetables (“Can’t stand the heat?,” page 14). Summer is a great time for family fun, but don’t forget to make time for yourself, too. Read about single mom and award-winning singer and actress Vanessa Williams’ tips for staying calm and grounded (“Enjoying the simple pleasures,” page 8). Stress can interfere with your good health, but Williams has discovered that the small things in life can ease her stress. Her strategies for stress-free living just might inspire you to find your own “simple pleasures.” Women’s Health Today gives you up-to-date, accurate and easy to understand health information. I’d love to hear from you; please let me know what topics you’d like to read about in future issues. Linda Brubaker, MD, Professor of Obstetrics and Gynecology, Urogynecology Urology, Loyola University Chicago Stritch School of Medicine; Co-Director, Women’s Pelvic Medicine Center, Loyola University Medical Center Vivien K. Burt, MD, PhD, Associate Professor of Clinical Psychiatry, The David Geffen School of Medicine at UCLA; Founder and Director, Women’s Life Center, UCLA Neuropsychiatric Institute and Hospital Vivian M. Dickerson, MD, Associate Clinical Professor of Obstetrics and Gynecology, University of California Irvine; Director, Division of General Obstetrics and Gynecology, UCI Medical Center; Director of UCI’s Post Reproductive Women’s Integrative Health Center Tommaso Falcone, MD, Professor and Chairman, Department of Gynecology and Obstetrics, The Cleveland Clinic Foundation; Co-Director, Center for Advanced Research in Human Reproduction and Infertility Sebastian Faro, MD, PhD, Clinical Professor of Obstetrics and Gynecology, Women’s Hospital of Texas Nieca Goldberg, MD, Assistant Professor of Medicine, SUNY Health Science Center, Brooklyn, New York; Clinical Assistant Professor of Medicine, New York University Thomas Herzog, MD, Professor of Clinical Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons; Director, Division of Gynecologic Oncology, Columbia University Medical Center, New York Barbara Levy, MD, Medical Director, Women’s Health & Breast Center, St. Francis Hospital, Federal Way, Washington; Assistant Clinical Professor of Obstetrics & Gynecology, Yale University School of Medicine; Assistant Clinical Professor of Obstetrics and Gynecology, University of Washington School of Medicine Wendy l. wright, ARNP, FAANP, Adult/Family Nurse Practitioner; Adjunct Faculty, Fay W. Whitney School of Nursing, University of Wyoming Th e C h r i s t H o sp i t a l S TAFF President and CEO Susan Croushore Vice President, Operations Victor DiPilla CNO/Vice President, Nursing Deborah Hayes Vice President, Marketing and Community Relations Heather Adkins Vice President, Medical Affairs Robert Strub, MD Vice President, Finance John Renner Editor Dana Johnson customer service Sincerely, For more information about services at The Christ Hospital, please contact Dana Johnson at dana.johnson@thechristhospital.com or (513) 585-0215. Women’s Health Today is published four times a year by The Christ Hospital, 2139 Auburn Avenue, Cincinnati, OH 45219, in conjunction with the Foundation for Female Health Awareness, PO Box 43028, Cincinnati, OH 45243. This is Volume 4, Issue 3. © 2008 by The Christ Hospital and the Foundation for Female Health Awareness. All rights reserved. Mickey M. Karram, MD PRESIDENT AND Co-Founder Foundation for Female Health Awareness Dr. Karram and his wife, Mona, are the founders of the Foundation for Female Health Awareness, a nonprofit organization dedicated to improving women’s health by supporting unbiased medical research and educating women about their health. Women’s Health Today The information contained herein is not a substitute for professional medical care or advice. If you have medical concerns, seek the guidance of a healthcare professional. Women’s Health Today magazine is part of Women’s Health Experience, the flagship program of the Foundation for Female Health Awareness. Women’s Health Experience is a unique initiative aimed at connecting women with healthcare experts, as well as their local hospitals, to learn about important issues that may affect their health. Through Women’s Health Experience regional conferences, Women’s Health Today magazine and www.womenshealthexperience.com, you’ll get objective, timely information. You can also sign up for free e-newsletters containing health news and results of medical studies. Sign up now at www.womenshealthexperience.com. c o v e r : Vanessa W i l l i a m s © 2 0 0 8 A nd y R y an / C o r b i s O u t l i ne No more pain A n o n s u r g i c a l treatment for uterine fibroids By Daniel E. Long, MD M ost women who have uterine fibroids just want their heavy periods and pelvic pain to go away. A well-proven revolutionary treatment called uterine fibroid embolization (UFE) is a better alternative to the traditional treatment of having a hysterectomy (removing the uterus surgically). My colleagues at Professional Radiology, Inc. and I have used UFE to treat more than 800 women with uterine fibroids. This nonsurgical treatment relieves troubling symptoms like heavy bleeding, prolonged monthly periods and pelvic pain. About 90 percent of the women with severe bleeding we’ve treated have seen a tremendous reduction in their persistent symptoms. An otherwise normal uterus can be home to several types of fibroids. Illustrations © John Yesko and BioSphere Medical What to expect The wonderful thing about UFE is that it doesn’t involve major surgery. The patient is mildly sedated and a catheter is inserted into an artery through a small incision in the groin area. The catheter is guided to the uterine artery, where small particles are injected. The particles starve the fibroid by blocking its blood flow, causing it to get smaller. Troublesome symptoms will get significantly better, usually within one to two menstrual cycles. The fibroids will shrink by at least 60 percent right away and continue to get smaller for up to a year after the procedure. If you have any of these difficult symptoms and want to avoid having a hysterectomy, you’re a likely candidate for this procedure. Because UFE is minimally invasive, women with other health concerns can be treated safely with this technique. Patients are usually in the hospital for less than a day and can return to their daily activities in about a week. WHT The uterine fibroid embolization procedure shrinks the fibroid by using tiny particles to cut off its blood supply. UFE help you? ! Can You or your physician can contact Professional Radiology, Inc., to learn more about how UFE can help with your painful or heavy periods. Call (513) 527-9999 or visit www.professionalradiology.com. Daniel E. Long, MD, is the medical director of interventional radiology services at The Christ Hospital Heart and Vascular Center. Dr. Long specializes in blood vessel procedures like uterine fibroid embolization. www.womenshealthexperience.com Safe summer fun How to keep sports injuries at bay By Judy Coleman, PT N ow that summer’s here, there’s nothing you’ll want to do more than get outside and play. Just make sure to do it safely. Whether you’re hiking, biking, skating, shooting hoops or kicking a ball around, take these precautions to guard against injuries. Warm up Give your muscles a good stretch before jumping into action. Do neck stretches, touch your toes and reach for the sky. If you have young children, disguise the warm-up as a game of “Simon says.” Stretching makes muscles less prone to tears or strains. Never bounce when you stretch, and hold each position for at least 15 seconds. Have fun No matter the chosen activity, make sure everyone’s familiar with the rules. Children should be supervised to prevent teasing or unfair playing. When you or a family member participates in an individual activity, such as biking or skating, review the laws of the land: Stay on the right side of the road, make appropriate hand signals, follow traffic signals and designate a place to meet in case you get separated. Be familiar with the playing area. Is the pavement level and well lit? Is the field smooth and clear? Make sure your child knows what’s safe play and what’s off limits. Cool down Great workout? Before you go home, cool down to prevent sore muscles. At home, a warm bath will help relax muscles. If you or your children have any pain, rest the sore muscle for a few days until it has recovered. If discomfort persists, seek medical attention. Never play through the pain. WHT ! Stay fit & injury free! If you or a family member suffers from sore muscles or more, The Christ Hospital Physical Therapy Centers may be able to help you. To see all that the center can offer you and your family, visit www.thechristhospital.com, or call (513) 585-7342. Judy Coleman, PT, is a physical therapist with the The Christ Hospital Physical Therapy Centers. Women’s Health Today By John M. Roberts, MD Garden without pain! P r otect your back with proper posture I s your back pain getting in the way of growing a great garden? Weeding and other outdoor chores can tire even strong backs and quickly turn pleasure into pain. As a fellow gardener, I have good news for you: Using correct posture can reduce your chance of sore muscles and help prevent back injury. Use these tips, and you’ll comfortably enjoy the fruits (and vegetables) of your labor. Stay flexible and straight of the other. Anchor your buttocks into the ground evenly, bringing your pelvis and spine into a balanced, upright position. Hands and knees Distribute your weight evenly between your hands and knees and pay attention to the position of your spine as you shift and move. Be sure your knees, hips and shoulders are aligned. Standing Prop your elbow or hand against your leg as you lean forward, creating a bracing effect for your back when you bend and reach. Use a wide stance, creating a stable base of support as you work. Heavy lifting Use common sense—don’t try to lift anything that’s too heavy to be picked up easily. Bend from the hips and knees instead of the waist, keeping your back straight and rising as if from a squatting position. Your hip muscles are more powerful and better equipped to deal with heavy loads than your back muscles. WHT Stretch your hamstrings—the muscle group in the back of each thigh—before and after working in the garden. Place your foot on a low bench or chair and lean forward to flex the muscles. And keep a “long” spine: no slouching, hunching your back or bending at the waist. Keep your spine straight and square with your hips. Sit on a bucket Sitting while you garden helps avoid putting pressure on your knees, hips and back. Bend at the hips, and keep your spine as straight as possible when sitting. Sitting on the ground If you have flexible hip joints and a relatively healthy lower back, you may sit on the ground to garden. Sit with your legs bent, with one in front ! Ease your aching back! To find out how John M. Roberts, MD, and other physicians at The Christ Hospital Spine Institute can help you, visit www.thechristhospital.com or call (513) 585-BACK (2225). John M. Roberts, MD, is surgical director of The Christ Hospital Spine Institute. www.womenshealthexperience.com health Women and their stroke risk are growing W omen’s middle-age spread is hiking their likelihood of having a stroke, say California researchers who analyzed data from the National Health and Nutrition Examination Surveys (NHANES) 1988–1994 and 1999–2004 and compared medical history variables, including heart attack, cholesterol, high blood pressure and smoking. The result? Women in NHANES 1999–2004 were significantly more obese than those in the 1988–1994 survey, and waist circumference had grown more than an inch and a half. Women in the later survey were more likely to have taken medication to control blood pressure and cholesterol; however, usual key risk factors—including obesity and average glycated hemoglobin, an indicator of poorly controlled blood sugar—had risen. Authors of the study, reported at an American Stroke Association conference, note that abdominal obesity is a known stroke predictor in women and may be a key contributor to rising stroke rates. Don’t refrain from whole grain! W hole grains contain all the naturally occurring nutrients of the entire grain seed. They help you not only achieve your weight-loss goals but also lower your risk for chronic conditions such as diabetes and cardiovascular disease. To prove it, investigators recruited 50 obese adults— 25 men and 25 women—ages 20 to 65 who had metabolic syndrome, a group of symptoms that increase the risk of developing cardiovascular disease and diabetes. Study participants were randomly assigned to either a group eating grain servings from whole grains or a group getting all grain servings from refined grains. Both groups received the same dietary advice about weight loss and were encouraged to participate in moderate physical activity. At the end of 12 weeks, both groups showed considerable decreases in waist circumference and body weight, but the whole-grain group showed significantly greater abdominal weight loss. The whole grain group also experienced a 38 percent drop in C-reactive protein, an inflammatory marker believed to increase risk for diabetes, hypertension and cardiovascular disease. Want to up your whole-grain intake? Read food labels when you’re shopping. “Whole grain” should be first on the ingredients list. Check the nutrition facts, too; foods high in fiber contain 5 or more grams of fiber per serving. Women’s Health Today what’s making news in women’s health headlines 4 lifestyle changes = 14 more years © 2008 Jupiterimages Dining with daughters C E ating meals with your adolescent daughters may make them less likely to use extreme measures to control their weight five years later. In making that determination, University of Minnesota researchers had more than 2,500 adolescents complete an in-class survey in 1999 to learn how often they ate with their families, their body mass index (BMI), feelings of family connectedness and eating behaviors. Five years later, study participants completed a mailed survey, which revealed that girls who’d reported eating five or more meals each week with their families as adolescents were significantly less likely to control their weight using extreme measures—diet pills, laxatives, binge eating and self-induced vomiting— regardless of such factors as BMI or family connectedness. Regular family meals didn’t predict healthy eating behaviors in boys, however. Authors of the study, published in Archives of Pediatrics & Adolescent Medicine, speculate that girls may be more sensitive to, and likely to be influenced by, interpersonal and family relationships present at family meals. hanging just four behaviors may increase your lifespan by nearly a decade and a half, say Cambridge University researchers. In questionnaires completed by 20,000 men and women ages 45 to 70, one point each was awarded for not smoking, eating five servings of fruits and vegetables a day, being physically active (inactivity was defined as having a sedentary job and not participating in any regular exercise) and consuming only moderate amounts of alcohol. After taking age, social class and body mass index into account, investigators found that over 11 years, study participants who’d scored zero were four times more likely to die than participants with a score of four. In addition, those scoring zero had the same risk of dying as participants 14 years older but with a score of four. www.womenshealthexperience.com 1 2 3 4 simple enjoying the pleasures “Ugly Be tt y” beauty Va ne ssa Williams finds happiness a t home By Bonnie Siegler T hese days, Vanessa Williams’ career is on a roll. Her current role on the hit TV show “Ugly Betty” as overthe-top fashion boss Wilhelmina Slater has brought her new acclaim. And that’s on top of a career that includes platinum records, starring movie roles and Emmy, Grammy and Tony nominations among her accomplishments. But being Mom to Sasha, Devin, Jillian and Melanie, ages 7 to 20, takes center stage in Williams’ heart and home. “I’ve been a mom so long it seems like half my life,” she says. Has Williams, who commutes between her Westchester, N.Y., home and Los Angeles, where “Ugly Betty” is filmed, found a balance between working and mothering? “No,” she readily answers. “I’ve really found no balance being a mom of four and working. It’s not going to be balanced when you’re working, because you’re not at home with your kids all the time.” But she doesn’t let guilt cloud her successes. “You have to make each moment work for you and surrender to the process. You can’t be guilt-ridden if you choose to live your life in a certain manner. The older I grow, the more I surrender to life. It gives me a sense of calm.” Being grounded Before her children came along, Williams, now 45, had to tackle Hollywood’s ups and downs. “This business is famous for loving you one second and then you’re over with the next,” she says. “That’s why I try to concentrate my life in a very normal community. None of my friends are really in this business—a lot of them I’ve known since grade school. Hollywood is where my job is, but my home is my sanctuary.” Back on the East Coast, Williams’ days are filled with car pools, school plays, after-school sports and regular church attendance. She’s on friendly terms with both of her ex-husbands, who are frequent guests at her home and attend school activities with the family. “I think it’s important for the kids to see their parents active in their lives, parents who love them and do things together,” she says. continued on page 10 Women’s Health Today © 2008 Joe Kohen/ WireImage e www.womenshealthexperience.com “ i like to find the ” simple pleasures in enjoylife them toand the fullest. A sense of family has always been the cornerstone to Williams’ strength and stability. Her Westchester home is only five miles from the family home where she grew up practicing French horn and piano. “My life was filled with music and creativity,” she fondly recalls of both her teacher parents. They encouraged her musically, but were also demanding academically. “It was a fantastic structure. I think I’ve become a woman who’s not afraid of life’s obstacles and challenges due to growing up with parents who were very clear in making their children’s lives independent—learning how to do things for yourself at an early age. It just makes you a more grounded person.” Finding little joys Part of Williams’ strategy to staying grounded— whether she’s working in Hollywood or relaxing with the kids at home in suburban New York—is reducing daily stress and finding satisfying activities. “I like to find the simple pleasures in life and enjoy them to the fullest,” she says. For example, when cooking up a batch of cookies or Williams gets glam with her “Ugly Betty” costars Becki Newton (left) and Ana Ortiz. 10 Women’s Health Today her popular lasagna dinner at her home, a dressed-down Williams listens to soft Brazilian music playing in the background. When driving to work in California, “I find music to listen to and thoroughly enjoy it,” she says. “When I have to spend five hours on a plane each week, I do some crossword puzzles because I love doing them. When I travel, I usually horseback ride just to see the area and nature because I love the outdoors. So it’s about finding the things that bring you joy in life.” Yoga is another grounding presence, adds Williams. “It’s relaxing and certainly helps relieve stress.” Relaxing with her kids is yet another key ingredient in calming the chaos of Williams’ life. “I always get a chuckle out of my kids,” she says. “Devin and I watched Blazing Saddles recently and we thought it was just hilarious. Again, it comes back to simple pleasures.” Feeling comfortable, strong and happy Williams “surrenders” to the simple pleasure of casual home attire that Wilhelmina Slater would be shocked to see. She describes her look as relaxed elegance: pretty even without makeup, her honey-colored hair pulled back in a ponytail, wearing comfortable clothing and sensible shoes. “I like to feel at ease in my clothes, and I rarely forfeit that for fashion,” she says. This down-to-earth approach affects how Williams takes care of her body. Feeling strong is a vital part of her self-image. She keeps her 5-foot-6-inch figure healthy by taking daily vitamins and supplements that include fish oil, flaxseed, multivitamins, chlorophyll and acidophilus. “I believe taking care of myself runs the gamut from taking care of my inside as well as my outside,” Williams says. And while soybeans, roasted chicken and spelt bread are grocery necessities, eggs, flour and sugar for the waffles her kids love are also on the list. When friends stop over, Williams pours a good wine and serves up some warm bread and a bit of chocolate. “A hot loaf of bread with butter. Good friends, great conversation and laughter. That’s my idea of a relaxing evening.” It sounds like Williams has found the recipe for a great life, too. WHT © 2008 Jason LaVeris/FilmMagic continued from page 8 ” sex & Gender matters The latest findings on women-specific health from the Society for Women’s Health Research By Jennifer Wider, MD Diabetes and sex Not always the best partners W e all know diabetes can take a toll on our overall health. But a common problem that’s rarely discussed is the impact diabetes can have on your sex life. About 35 percent of women with diabetes may experience some form of sexual dysfunction related to the disease, according to the Joslin Diabetes Center in Boston, Mass. And new studies have shown a link between sexual dysfunction and depression in women with diabetes. From physical to sexual problems © 2008 Joshua Sheldon In addition to the psychological effects, women with diabetes who suffer from sexual dysfunction often have a wide variety of complaints associated with the physical complications of their disease. Nerve damage from diabetes can result in a decline in sexual arousal and desire. Women with diabetes are more likely to have problems with decreased vaginal lubrication and may suffer from recurring vaginitis (inflammation of the vagina) as a result of yeast infections, making sexual intercourse painful. Researchers suspect the loss of sexual desire is triggered by diabetes’ impact on the body’s metabolism and adrenal and thyroid functions, but more study is needed to understand these complex processes and possible treatments. Help is available Depending on the underlying cause, various treatments can help relieve these sexual dysfunctions. An open, honest discussion with your healthcare ! Learn more! The Society for Women’s Health Research is a nonprofit research, education and advocacy organization that works to improve women’s health through sex-specific research, education and advocacy. For more of the latest news and research on women’s health, visit their Web site at www.womenshealthresearch.org. provider is the key to finding the specific cause and the right therapy for your situation. Although the number of people suffering from diabetes is at an all-time high, you can cut your risk by maintaining a healthy lifestyle. “Exercise 30 minutes a day, five to seven days a week, and keep your weight under control with a healthy diet,” says K. M. Venkat Narayan, MD, former chief of the Diabetes Epidemiology and Statistics Branch at the Centers for Disease Control and Prevention in Atlanta, Ga. WHT Jennifer Wider, MD, is a medical advisor for the Society for Women’s Health Research in Washington, D.C. www.womenshealthexperience.com 11 5 Annual th TM OCTOBER 11, 2008 • Duke Energy Center • Cincinnati, Ohio Save the date for a fun-filled day focusing on your health! Presented by: Register now and pay only $30. After September 1, pay $40. www.WomensHealthExperience.com The 5th Annual Women’s Health Experience will feature educational sessions on timely, practical issues presented by local physicians, a variety of health screenings, a gala luncheon, a keynote address, and an exhibit hall full of professionals— all there to help you take charge of your health and well being. So take some time out for your health. Gather your mother, daughters, sisters, friends—and join us! Last year’s event sold out in advance. But you can register now and save. To register, invite a friend, or simply get more information, go to www.WomensHealthExperience.com. To register by phone, call Barbara Bunt at (513) 463-2512. Healthy bites Can’t stand the heat? Get out of the kitchen! G a z p ach o Serves 7 • 6 cups peeled and chopped tomatoes (8 to 9 medium) or canned no-salt-added Italian plum tomatoes • 1 medium onion, coarsely chopped (about ½ cup) • ½ cup green bell pepper, coarsely chopped • ½ cup cucumber (peeled if outer skin is tough), coarsely chopped • 1 medium clove garlic, minced, or ½ tsp. bottled minced garlic • 2 cups no-salt-added tomato juice • ¼ cup red wine vinegar • ½ tsp. sugar • ½ tsp. ground cumin (optional) • 1⁄8 to ¼ tsp. pepper — In a food processor or blender, puree tomatoes, onion, bell pepper, cucumber and garlic in batches. Pour each batch into a large bowl. Add tomato juice, vinegar, sugar, cumin and pepper, stirring well. Cover and refrigerate for at least 30 minutes. Ladle into serving bowls. Sprinkle with croutons and garnish with additional finely chopped cucumber, tomato, pepper and onion if desired. — Per serving: 59 calories, 1 g total fat, 0 mg cholesterol, 22 mg sodium, 13 g carbohydrates, 3 g fiber, 2 g protein 14 Women’s Health Today When the temperature soars and the air conditioner struggles to cool your home, the last thing you want to do is stand in front of a hot oven. But that doesn’t mean you have to give up healthy, appetizing fare. Take advantage of the season’s bounty and visit a farmers’ market for fresh fruits and vegetables—and forget the oven. Instead, rev up the blender and light the grill. Escape your hot kitchen and enjoy these refreshing foods prepared with minimal heat. Summery f ruit salad with quinoa Grilled pork- andve ge table pi tas Serves 5 • 1 cup uncooked quinoa, thoroughly rinsed and drained • ½ medium to large cantaloupe • 1 small jicama (8 to 9 oz.) • 1½ cups seedless grapes • 2 large stalks of celery • 8 oz. nonfat lemon yogurt • 2 tbsp. fat-free or reduced-fat mayonnaise dressing • 1 tbsp. balsamic vinegar • ¼ tsp. salt • ½ cup plus 2 tbsp. dry-roasted walnuts, coarsely chopped • 3 tbsp. fresh mint, chopped or thinly sliced, plus 5 sprigs for garnish • 1 lime, cut into 5 wedges — Cook quinoa according to package directions, omitting salt and oil. Transfer quinoa to a large, chilled bowl. Once quinoa has cooled to room temperature, cover with plastic wrap and refrigerate until completely chilled. Meanwhile, dice cantaloupe, peel and dice jicama, halve the grapes and slice celery on the diagonal; refrigerate in separate containers. At serving time, whisk together yogurt, mayonnaise, vinegar and salt, and stir into quinoa. Drain cantaloupe and stir with jicama, grapes, walnuts and 3 tbsp. mint into quinoa. To serve, place two 1-cup scoops of salad on each plate. Garnish with a sprig of mint and a lime wedge. — Serves 4 • 3 tbsp. Dijon mustard • 3 tbsp. red wine vinegar • 2 tsp. olive oil • 2 medium garlic cloves, minced • ¼ tsp. pepper • 8 oz. nonfat or low-fat plain yogurt • 1 lb. pork tenderloin, all visible fat discarded, cut into ¾-inch cubes • 14 medium button mushrooms, halved • 1 medium red bell pepper, cut into ¾-inch pieces • ½ medium onion, cut into ¾-inch pieces • 4 6-inch whole-wheat pita breads, halved crosswise — In a small bowl, stir together mustard, vinegar, oil, garlic and pepper. Stir 1 tbsp. of this mixture into the container of yogurt; refrigerate. Preheat grill to medium-high heat. On eight 10-inch metal skewers, alternately thread pork, mushrooms, bell peppers and onions. Grill kebabs for two minutes on each side, or until pork is browned. Brush mustard mixture without yogurt on all sides of kebabs; grill for one to two minutes on each side or until pork is no longer pink in the center and vegetables are tender. To serve, remove the meat and vegetables from a skewer and place in half a pita bread. Top with 2 tbsp. of the refrigerated yogurt sauce. Repeat with remaining kebabs and yogurt sauce. — Per serving: 350 calories, 12 g total fat (1.5 g saturated, 8 g polyunsaturated, 2 g monounsaturated), 1 mg cholesterol, 227 mg sodium, 53 g carbohydrates, 7 g fiber, 23 g sugar, 10 g protein Per serving: 402 calories, 9 g total fat (2.5 g saturated, 1.5 g polyunsaturated, 4 g monounsaturated), 76 mg cholesterol, 689 mg sodium, 44 g carbohydrates, 6 g fiber, 8 g sugar, 36 g protein Recipes adapted with permission from American Heart Association One-Dish Meals, copyright © 2003 and The New American Heart Association Cookbook, copyright © 2001. Published by Clarkson Potter/Publishers, a division of Random House, Inc. Available from booksellers everywhere. www.womenshealthexperience.com 15 Why so many headaches? Headache Experts suspect several factors contribute to frequent headaches, including: • Female gender. Probably because of hormonal fluctuations, more women than men suffer from headaches. • Faulty brain function. The brain’s response to pain, tissue inflammation and muscle tension can malfunction, resulting in chronic pain. • Genetics. Some people inherit a predisposition to headaches and increased pain sensitivity. • Medication overuse. When you use headache medications more than two or three days a week, they can aggravate the problem, causing a “rebound” headache. Both over-the-counter and prescription medications can be to blame. • Underlying health problems. Chronic headaches may be associated with other conditions like infection, sleep disorders, depression, anxiety, inflamed blood vessels, brain tumor or head injury. T a k e a p r o a c t i ve approach to end the pain M ost everyone gets a headache now and then. But for 4 percent to 5 percent of the adult population, a headache is a daily agony. If you suffer from painful chronic headaches, learn what you can do before the next one hits. Head notes Chronic headaches strike often—at least 15 days a month and sometimes daily. Some are really migraines—unrelenting pain on one or both sides of the head, sometimes with nausea and light sensitivity. Others are tension-type headaches that feel like a band tightening across the head. Physicians can’t always pinpoint the cause, but sometimes pain is triggered by surgery, an infection or a stressful life event. 16 Women’s Health Today Chronic headaches can take a toll on your life, both physically and emotionally. It’s time to see your healthcare provider if you take pain medication nearly every day, if you suffer from headaches three or more times a week, if you need more than the recommended dose of pain reliever or if your headaches worsen or change in pattern. If your provider finds no medical cause, he or she may suggest one of the following treatments to help prevent your headaches: • antidepressants to restore the brain chemical serotonin, which helps regulate pain sensitivity • seizure-control drugs to calm the “excitability” of the brain’s pain pathways • antimigraine medications that constrict inflamed blood vessels and prevent them from pressing on sensitive nerves • relaxation training like guided imagery and deepbreathing exercises • behavior therapy to manage stress and anxiety • acupuncture to help reduce the amount of pain medication needed WHT © 2008 Jupiterimages Seeking speedy relief Skin type your sunscreen F i n d t h e r i g h t protection for your skin C hoosing from the array of sunscreens available today can make a simple thing like sun protection feel like a chemistry lesson. Experts urge wearing a waterproof, broad-spectrum sunscreen with a sun protection factor (SPF) of at least 15. But what does that mean? Here’s what you need to know about sunscreens. Which skin types need to wear sunscreen every day? All of them. The American Academy of Dermatology (AAD) recognizes six different skin types, ranging from type I (pale skin that always burns easily) to type VI (deeply pigmented or black skin that never burns). All skin types need to use sunscreen daily to prevent the sun damage that causes premature aging and skin cancer. What does broad-spectrum mean? Sunlight consists of two types of damaging rays. Ultraviolet B (UVB) rays are the primary cause of sunburns and skin cancer. Ultraviolet A (UVA) rays penetrate deeper into the skin and contribute to skin damage, burns and cancer. The immune system, which helps protect you from developing skin cancer, is suppressed by both UVA and UVB rays. © 2008 Jupiterimages ! Sunscreen ingredients like PABA and PABA esters protect against UVB rays only. For a broadspectrum sunscreen that helps protect against some UVA rays, look for ingredients like benzophenones, oxybenzone, sulisobenzone, titanium dioxide, zinc oxide and avobenzone (Parsol 1789). Are higher S PFs better? The SPF—a number ranging from two to 50 or more—rates a sunscreen’s ability to deflect UVB rays. An SPF of 50 doesn’t necessarily provide double the protection of an SPF of 25. An SPF of 30 for example, deflects 97 percent of the sunburning rays, compared to 93 percent for an SPF of 15. However, the AAD says fair-skinned people who burn easily should use products with the higher SPFs. Last year, the Food and Drug Administration announced a UVA protection star rating system, from one (low) to four (high). While manufacturers aren’t required to use these ratings on their labels until sometime next year, expect some to start promoting their UVA protection sooner. WHT Prevent skin cancer! The Christ Hospital Cancer Center offers a full range of the most advanced cancer services available, including research, early detection, prevention, education and treatment. For your copy of our Eight Ways to Prevent Skin Cancer bookmark, call (513) 585-0215 or e-mail dana.johnson@thechristhospital.com. www.womenshealthexperience.com 17 Controlling cancer’s side effects Is complementary W therapy hen you’re fighting cancer, it’s American Cancer Society. “But public natural to seek the best treatinterest has motivated researchers and right ment available. For many, this clinicians to test many complementary for quest leads to unconventional therapies the same way they would therapies, like acupuncture and massage. conventional therapies.” you? Although no cancer expert would approve For example, yoga, tai chi and of using such remedies in place of stanmeditation have been shown to help dard treatment, physicians are increasingly helping people cope with cancer symptoms and side effects, Dr. Gansler says. On the other hand, “anything that patients add these methods to their treatment plans in a practice known as integrative, or complementary, says cancer can be cured without conventional treatmedicine. ment or claims of a secret alternative cure is a sure Many nontraditional therapies can help ease side sign of something to avoid,” he says. effects from cancer and its standard treatments, such as pain, nausea and anxiety. To benefit from the best Ask questions. of both worlds, follow these steps: Write down any questions about the therapy and bring them with you to your next medical appointment. Bring a friend or family member along to help take notes. Do your research. Investigate a potential therapy and gather information. Seek credible health sources, such as major Talk with your healthcare team. cancer center Web sites, scientific journals and If you’re considering a complementary treatgovernment agencies. ment, first ask your healthcare team for advice. “Until about 10 years ago, there was little scienShare with them any information you’ve gathered. You and your team must determine that the treattific research on complementary medicine,” says Ted Gansler, MD, director of medical content for the ment won’t interfere with your medical treatment. 2 1 3 ASK THE EXPERT Featuring Ted Gansler, MD Q: I s i t t r u e t h a t t a k i n g m e g a d o s e s o f v i t a m i n s c a n h e l p f i g h t c a n c e r ? A: There’s little evidence that high doses of supplements have any benefits for people with cancer. Some supplements may even increase the risk of developing cancer—studies found that to be the case for smokers who take vitamins A and E and beta-carotene. More beneficial to cancer patients is eating a balanced diet with plenty of fruits and vegetables and limited red and processed meats and alcohol, getting regular physical activity and maintaining a healthy weight. These measures can help prevent many forms of cancer, improve the quality of life for those living with the disease or reduce the risk of cancer recurrence. ! 18 Women’s Health Today Ask the doctor If you find your doctor isn’t open to the idea of complementary therapy, you can seek a second opinion, Dr. Gansler says. 4 Be honest about your supplements. Make a list of any supplements, vitamins, herbs or other nutrients you take and discuss it with your physician, pharmacist or nurse. Some seemingly harmless supplements may interact with medications or interfere with a standard treatment. For example, St. John’s wort, an herbal supplement for depression, changes how chemotherapy drugs are metabolized in the body. 5 let your healthcare team help. Tell your team why you want to explore other options. Are side effects of standard treatments becoming intolerable? Speak candidly to help your providers guide you to the best possible therapies. ! Feel better today! The Christ Hospital Cancer Center is proud to offer tai chi classes on Fridays and yoga classes on Tuesdays for cancer patients, survivors and their caregivers. There’s no need to sign up, just join us when you’re able. Call (513) 585-2323 for times and location. 6 Stick to your treatment plan. 7 Ask for alternatives. Don’t postpone or skip any treatments your oncologist has planned. Talk to your physician if symptoms or side effects are making it difficult for you to stay on schedule. If the complementary treatment could interfere with your standard cancer therapy, ask your physician for safer options. Many conventional therapies can help relieve or control side effects. WHT www.womenshealthexperience.com 19 Waiting for baby O ! 20 Be ready when baby comes! The Christ Hospital Birthing Center offers a wide range of childbirth education classes, covering every topic expectant parents need to know. For a list of services and class schedules, or to arrange a tour, call (513) 585-HUGS (4847). Women’s Health Today ne in eight babies in the United States is born prematurely—before the 37th week of pregnancy. When a baby makes his or her entrance too early, it sets the stage for a host of health concerns, including brain, breathing and digestive problems, and possibly death. While you can’t necessarily control certain risk factors for premature delivery—pregnancy with multiple babies, uterine or cervical abnormalities and previous preterm birth—you can take measures to ensure your baby doesn’t make an early appearance: • G e t r egu la r p r e nat al c ar e . Talk with your healthcare provider about any troublesome symptoms. Learn the signs of preterm labor and what to do if they occur. • Man age c h r o ni c c o n di t io n s . Some conditions, such as uncontrolled diabetes or high blood pressure, put you at risk for preterm labor. Your healthcare provider can help you manage them. • Eat h ea l t hful l y . Additional amounts of folic acid, calcium, iron and protein—as well as regularly taking a prenatal vitamin before conception—can help keep you and baby healthy. • R e du c e s t r e s s . Don’t take on more than you can handle, and get plenty of quiet time each day. If you need help, ask for it! • Giv e y ou r t e e t h s om e TLC. Gum disease has been linked to preterm birth, so brush and floss daily and get regular dental checkups. • B e car e ful w ha t y ou p u t in t o y ou r b o d y . Smoking, drinking and recreational drugs are obvious no-no’s. Be cautious with over-thecounter supplements and medications, too. Tell your healthcare provider about any herbs, vitamins, supplements and medicines you’re taking. • Ask your healthcare provider about appropriate activities. If you’ve had problems with your pregnancy, he or she may recommend working fewer hours, spending less time on your feet or avoiding intimacy (especially if you have cervix or placenta problems). WHT © 2008 Jupiterimages Reduce your risks for premature birth The food-mood connection 5 w a y s t o s t op emotional eating W hen the going gets tough, the tough often head to the kitchen. That’s because food can comfort, distract and, in some cases, actually soothe. Chocolate, for example, can release tiny amounts of mood-elevating substances into your bloodstream, helping you quickly feel better. But as anyone who’s ever reached for a candy bar in a crisis knows, eating out of stress can pack on the pounds. Don’t let your feelings get the best of you. Try these five tips to lick emotional eating for good: 1 L ook f or comfo r t be y o n d t h e cu p b o ar d . Instead of grabbing a cookie in troubled times, try reading, calling a friend or taking a walk. With a little time to unwind and de-stress, you may feel you don’t need that sweet fix after all. morning, when you may be feeling fresher and more resilient. 5 Tak e car e o f y o u r s e lf. Eat a nutritious, well-balanced diet, get enough sleep and exercise regularly. These healthy lifestyle habits can help improve your ability to handle stress and make you less likely to succumb to emotional eating. If your emotions cause you to overindulge, don’t give up your healthy ways completely. Learn from the experience, forgive yourself and start again the next day. WHT 2 Ride o ut cr av ing s . When you feel like you’ve just got to have that chocolate, try resisting the urge; cravings often pass in a matter of minutes. 3 Pra ct ice damag e c o n t r o l . Keep your kitchen stocked with healthier snacks and treats like low-fat ice cream, sugar-free chocolate pudding, fresh fruit and whole-grain crackers. If you normally reach for something salty and crunchy when you’re upset, try popcorn instead of chips. 4 Avo id you r trigg e r s . Does your mom’s daily 3 p.m. call send you straight to the vending machine? Let the call go to voice mail occasionally. Or talk to her in the © 2008 Jupiterimages ! When all else fails Have you tried over and over to lose weight, but with no lasting results? Let us help! Learn about weight-loss surgery from the experts at The Christ Hospital’s Bariatric Center of Excellence. For a description of the surgery or our information session schedule, visit www.thechristhospital.com and click on “Departments,” then “Surgical Weight Loss.” www.womenshealthexperience.com 21 Healthy moves 36 37 38 Don’t let obesity prevent activity O ne-size-fits-all exercise options B eing active when you’re obese can be a challenge. It may be difficult to find exercise equipment that supports you. Bending or moving a certain way may feel uncomfortable or impossible. You may be self-conscious exercising around other people. But activity is essential to a healthy lifestyle. It can help ward off type 2 diabetes, heart disease, stroke and high blood pressure. If you already have these health problems, working out can ease your symptoms. Regular activity also reduces stress, helps build bone, boosts your heart and lung function and helps you sleep better at night. And the best news? You can be physically active no matter what your size. Get physical 1 Nonweight-bearing workouts put less stress on your joints because you’re not lifting or pushing against your own weight. R e c omm e n d e d : Water workouts, because you can bend and move in ways that may not be possible on land. And the water keeps you cool while you’re hard at work! Check your local recreation center or pool Tips! to see whether it offers classes with certified instructors. A group water aerobics class is a great way to get motivated. Try shallow-water workouts, keeping water levels between your waist and chest, which allows you to move your arms more easily. To give your whole body a good workout, opt for deep-water exercises, keeping most of your body underwater. Wear a life jacket or foam belt for safety. Incorporate beach balls, kickboards or foam dumbbells to make your workout more fun. © 2008 Jupiterimages Before you start any physical activity, talk with your healthcare provider. Experts recommend at least 30 minutes of moderate activity on most, if not all, days to help you maintain a healthy weight. But you’ll need at least 60 minutes a day to drop excess pounds. Sound impossible? It’s not. Break up your daily exercise into more manageable bites—for example, three or more 10-minute sessions. Health experts agree that a little activity is better than none at all. Consider the following three types of activity: 22 Women’s Health Today 39 40 Reco mmended: Bicycling, because it doesn’t put stress on any one part of the body; instead, it evenly distributes weight over your arms, back and hips. You can pedal away on an indoor stationary bike or outdoors on a road bike. Try a recumbent bike indoors. It seats you Tips! lower to the ground, and your legs have to reach for the pedals. You’re in a reclining position and the seat is wider, so you may be more comfortable. For outdoor rides, try a mountain bike, which has wider tires. And don’t forget the helmet! Make sure the bike’s weight rating is suitable. 2 Weight-bearing activities force you to lift or push against your body weight. You don’t need special equipment to benefit. Reco mmended: Walking, because it gets you moving, helps build healthy bones, is easy to do and costs no more than a good pair of shoes. Avoid feeling selfconscious by strolling through a park instead of walking at a gym. Start slowly. Walk for up to five minutes a Tips! day the first week. When you feel comfortable, slowly add time to your walks, and start walking faster. Wear comfortable walking shoes with substantial support. If you’re a frequent walker, talk with a podiatrist about how often you should replace your shoes. Walk in places you like—for example, a park or playground. Take a friend or a pet with you, or try listening to music or audio books to make your walk even more enjoyable. 41 42 3 Lifestyle activities such as vacuuming count toward your daily physical activity and can help improve your health. You can modify some of your activities to make them harder. And, this type of physical activity doesn’t have to be planned. Ditch the TV remote and get up to change Tips! the channel. March in place during TV commercials. Skip the elevator and take the stairs. Walk to your co-worker’s office rather than calling or e-mailing. If you’re still not sure how to get started, talk with your healthcare provider. And remember: No matter what activity you choose, any amount of movement is a step to a healthier you. WHT Know when to cool it If you experience any of the following symptoms while exercising, stop what you’re doing: p ain, tightness or pressure in your neck, chest, shoulder or arm d izziness or sickness c old sweats m uscle cramps s hortness of breath joint, foot, ankle or leg pain If symptoms don’t lessen after several minutes, seek medical attention promptly. If the symptoms disappear, don’t resume the activity; call your healthcare provider for guidance. Health smarts Are you sun-smart? A re you a sunburn victim waiting to happen? Or are you as sun-savvy as they come? Test your knowledge by answering true or false to the statements below. Then check the answers on this page to see how you did. True or false? {1} Having a large number of moles is a risk factor for skin cancer. {2} You can’t get a sunburn on a cloudy day. {3} Experts recommend you apply sunscreen when you first get outside. {4} The sun’s rays are at their strongest from 10 a.m. to 4 p.m. {5} Tanning beds are safer than sunbathing. Answers {1} TRUE. Having many normal moles or one or more atypical moles increases your risk for skin cancer. That’s why it’s important to check your skin regularly for any ! Test your health knowledge online Take more health quizzes and assessments online at www.womenshealthexperience.com. Plus, find out what other women are saying by participating in our online polls! 24 Women’s Health Today signs of change. Do you have any new growths? Have they changed in size or appearance? Do they bleed? See your doctor. Skin cancer is treatable if caught early. {2} False. Ultraviolet rays penetrate through clouds and haze and reflect off of water, sand, snow and even concrete. Protect yourself with regular sunscreen use. {3} False. Experts recommend you apply sunscreen 15 to 30 minutes before going outside. Make sure to cover those often overlooked areas of the body, such as your ears and scalp. Lips can also get burned, so don’t forget to apply a lip balm with a sun protection factor (SPF) of 15 or higher. {4} True. Look for shade or wear clothes and a hat during these hours. {5} False. Although some tanning salons say their tanning beds are safer than sunbathing, tanning beds also produce skin-damaging UV light that can lead to premature aging and skin cancer. In some cases, tanning-bed rays may be stronger than sunlight. Presented by with www.womenshealthexperience.com 5IFPGGJDJBM8FCTJUFPGUIF8PNFOT)FBMUI&YQFSJFODF5. CSJOHTZPVIFBMUIOFXTBOEJOGPSNBUJPOKVTUGPSXPNFO FYDMVTJWF 8PNFOT )FBMUI &YQFSJFODF5. VQEBUFT POMJOF JTTVFTPG8PNFOT)FBMUI5PEBZBOENVDINPSF r4JHOVQGPSBNPOUIMZ r5BLFPVSPOMJOFIFBMUI FOFXTMFUUFSUIBUEFMJWFST BTTFTTNFOUTUPMFBSOZPVS UIFMBUFTUIFBMUIOFXTUSFOET SJTLGPSDPNNPOEJTFBTFT BOEUJQTUPZPVSJOCPY*UT BOEDPOEJUJPOT GBTUFBTZBOEGSFF r'JOEPVUXIBUPUIFSIFBMUI r5FTUZPVSIFBMUITNBSUTPO NJOEFEXPNFOBSFUIJOLJOH GJUOFTTOVUSJUJPOEJTFBTF CZQBSUJDJQBUJOHJOPVSPOMJOF QSFWFOUJPOBOENPSFXJUI IFBMUIQPMMT PVSPOMJOFRVJ[[FT r3FHJTUFSGPSVQDPNJOH 8PNFOT)FBMUI&YQFSJFODF5. FWFOUTQMVTFYQMPSFUIF MBUFTU8PNFOT)FBMUI &YQFSJFODF5.OFXTMFBSO BCPVUGFBUVSFETQFBLFSTBOE GJOEPVUXIBUUIF8PNFOT )FBMUI&YQFSJFODF5.DBO PGGFSZPV It’s all here — and it’s all for you at www.womenshealthexperience.com Th e C h r i s T h o s P i TA l B i r T h i n g C e n T e r Delivering peace of mind for more than 100 years “A child is the greatest poem ever known.” —Christopher Morley, 1921 Call 585-HUGS to receive a catalog of our Childbirth Education for the Entire Family. Also, Beautiful. Perfect. Amazing. be sure to log on to www.the parentreview.com/christhospital to sign up for our FREE At the moment of birth, what words will be ParentCare emails. profound enough to introduce the great poem of your child’s life? No matter how your family chooses to express the wonder and joy of parenthood, you deserve a unique birth experience created by your own expectations and lifestyle. • • • • • • All private rooms Feng Shui Birthing Suites Hydrotherapy Laboring Suite Special Care Nursery Infant Security System Expert Neonatal and Perinatal Care Know what to expect when you’re expecting!